Leading Causes of Death

If you last looked at a list like this during the pandemic, throw it away. COVID-19 has fallen out of America's top ten entirely, and worldwide it has slid to twentieth. The list has quietly gone back to what it looked like in 2019 — which is to say, back to the things that were always going to get us.

Morty finds this reassuring in a way most people don't. The boring causes are the predictable ones, and the predictable ones are the ones you can occasionally argue with.

America's top ten, 2025

These are the freshest mortality figures that exist anywhere — the CDC published them on 2 July 2026, covering 99.9% of last year's death records. Two things jump out. Heart disease and cancer between them account for more than two in every five deaths in the country. And influenza and pneumonia climbed from eleventh place to eighth, which is the sort of quiet, unglamorous change nobody writes headlines about.

Note who isn't there. COVID-19 dropped out of the top ten in 2024 and stayed out in 2025. Suicide slipped from tenth to eleventh, with 48,789 deaths. Neither of those is a rounding error; both represent tens of thousands of people who are alive who wouldn't have been a few years ago.

But what's actually coming for you?

Here's the thing the all-ages list hides. That top ten is really a portrait of people over 65, because that's where most deaths happen. It describes almost nobody under 40.

Pick your age bracket and watch the list rearrange itself:

The pattern is stark. Up to your mid-forties, the leading cause of death is unintentional injury — falls, overdoses, crashes, the ordinary chaos of being alive and mobile. Chronic disease barely features. Then somewhere in the 45–54 bracket the handover happens: cancer takes the top spot, heart disease crowds in behind it, and the list starts to resemble the one everybody thinks of as "the" leading causes of death.

Which means the health advice that matters most is roughly the opposite of what people assume. Under 45, your mortality is mostly about behaviour and environment. Over 55, it's mostly about biology and accumulated wear. Morty has watched this changeover happen a few hundred million times and still finds the abruptness of it impressive.

Fear versus reality

People are magnificently bad at this. We are frightened of sharks, terrorism and aeroplanes, and largely relaxed about the couch. So here is the comparison, on a chart that has to use a logarithmic scale — because on a normal one, every bar except the last would be an invisible smear against the left edge.

Read it slowly. American heart disease gets through the entire worldwide annual shark death toll about every seven minutes. Every commercial aviation death on Earth last year — all 394 of them — adds up to roughly five hours of American heart disease. Terrorism worldwide, a record low in 2025, is about three days of it.

None of this means the fear is irrational, exactly — we're wired to notice the sudden, the vivid and the deliberate, and to ignore the slow. It just means the wiring is calibrated for a world we don't live in any more.

The rest of the world

Globally the picture is broadly similar but not identical. The most recent comprehensive estimates — the Global Burden of Disease study, published in The Lancet in October 2025 — cover 2023, when 60.0 million people died worldwide. The leading causes were:

1. Ischaemic heart disease — the same champion as always, and the largest single cause of death on the planet.
2. Stroke — the other half of the cardiovascular problem.
3. Chronic obstructive pulmonary disease — lungs worn out by smoking and by air you can't choose not to breathe.
4. Lower respiratory infections — pneumonia, still the deadliest infectious disease on Earth.
5. Neonatal disorders — the one that has no equivalent in the American list, and the one that has improved most: down from 5.2 million deaths in 1990 to 2.3 million in 2023.

Cardiovascular disease alone accounted for 19.2 million deaths in 2023 — roughly one in every three deaths worldwide, up from 13.1 million in 1990 as the world's population grew older and larger. And COVID-19, which was the world's second leading cause of death in 2021, had fallen to twentieth by 2023.

Sources: GBD 2023 Causes of Death Collaborators, The Lancet, October 2025; IHME cardiovascular burden report, 2025. There is no global cause-of-death data for 2024 or 2025 yet — worldwide mortality estimates run roughly two years behind, so 2023 is genuinely the newest year available.

The bigger pattern

Step back and the story is not actually a grim one. Seven of the world's ten leading causes of death are now noncommunicable — the chronic conditions of long lives. A century ago the list was infections, and most of the dying was done by children. Today, for most of the world, the top killers are what you get to die of if nothing else gets you first.

The American death rate in 2025 was the lowest ever recorded. The global neonatal death count has more than halved since 1990. These lists are grim reading taken one line at a time, but the direction of travel across a lifetime is unambiguously good. Many of these "top killers" are a side effect of success — more people are living long enough to die of old age rather than of being three.

Morty's professional view, for what it's worth: the guest list never gets shorter, but people are arriving considerably later than they used to.

See also how these patterns play out geographically in life expectancy by country, or the famous names who ran out of road on this exact date. Want the lighter side of mortality statistics? Our death date calculator turns the whole grim business into a joke at your expense, and you can read how it (doesn't) work on the how it works page.

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